Basic Blood Exam

Question 1

Identify the cells types present on the attached peripheral blood smear.

Answer 1

Red arrow - Platlets
Yellow arrow - Neutrophils
Green arrow - Basophils
Purple arrow - Monocytes
No arrow - RBCs

Question 2

Macrocytic RBCs are most associated with what cause?

Answer 2

B12 or Folate Deficiency

Question 3

CD16 & CD56 are most associated with what cells?

Answer 3

NK Cells

Question 4

Patients with sickle cell disease have RBCs with a crescent appearance. What is the name for this RBC shape?

Answer 4

Drepanocytes

Question 5

All T lymphocytes have this protein marker on their surface.

Answer 5

CD3

Question 6

These are random clusters of RBCs.

Answer 6

Agglutination

Question 7

Bone marrow cellularity naturally decreases with age. What replaces these stem cells?

Answer 7

Adipocytes

Question 8

What are band cells?

Answer 8

Premature neutrophils

Question 9

Monocytes mature into macrophages. How is their histologic appearance described?

Answer 9

Cells with an indented nucleus and ground-glass cytoplasm

Question 10

These RBCs are twice as long as they are wide.

Answer 10

Elliptocytes

Question 11

What are the contraindications to a bone marrow biopsy?

Answer 11

Inability to properly form clots, infection close to site, radiation exposure at site

Question 12

A CBC is run and an RBC is described as microcytic. What lab result was utilized to make this classification?

Answer 12

Mean Corpuscular Volume (MCV)

Question 13

Eosinophils contain granules with what enzyme?

Answer 13

Histaminase

Question 14

Microcytic RBCs are most associated with what cause?

Answer 14

Iron deficiency

Question 15

Howell-Jolly bodies are nuclear remnants in mature RBCs. In what patients are these most commonly found?

Answer 15

Patients without a spleen

Question 16

What protein markers are located on all B lymphocytes?

Answer 16

CD19, CD20, CD21

Question 17

How can codocytes be described?

Answer 17

AKA target cells - RBCs with a ring of central pallor surrounding a central circle of a hemoglobinized membrane

Question 18

These histological findings are characteristic of G6PD.

Answer 18

Heinz Bodies and Bite Cells

Question 19

RBCs are derived from what cell lineage?

Answer 19

Myeloid Stem Cells

Question 20

What are the general indications for a bone marrow study?

Answer 20

Diagnosis of disease, staging of malignancy, monitoring treatment or disease progression

Question 21

This RBC shape is characterized by spiny projections and central pallor.

Answer 21

Echinocytes (Burr Cells)

Question 22

Basophilic stippling is due to clusters of RNA-containing ribosomes within RBCs. With what pathology are these most associated?

Answer 22

Lead Poisoning

Question 23

True/False. Bone marrow biopsies produce fresh tissue.

Answer 23

False - tissue must be “fixed” due to calcification. Bone marrow aspiration provides fresh tissue

Question 24

True/False. Red Cell Distribution Width (RDW) is a measure of variation in the size of RBCs. This value should be zero, except in cases of anemia.

Answer 24

False - RDW generally ranges from 11.5-14.5%. It increases in cases of anemia and liver disease.

Question 25

Dacryocytes have a teardrop or pear shape. What is the cause of this RBC abnormality?

Answer 25

Myelofibrosis

Question 26

This RBC shape is characterized by spiky spherocytes without central pallor.

Answer 26

Acanthocytes ( Spur Cells)